Body modification -- or mutilation?

Becoming something else – Dennis Avner, aka "Cat Man," arrives at a 2007 party for "Ripley's Believe It Or Not Odditorium" in New York. Avner died last year of an apparent suicide.

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Becoming something else – Filipino fashion designer Herbert Chavez underwent plastic surgery to transform himself into Superman. He had his nose thinned and a cleft made in his chin. He also had silicone injected for fuller lips, liposuction to flatten out his abdomen and implants to bulk up his buttocks and hips.

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Becoming something else – A man at Venezuela Tattoo Expo in January appears as "Satan," complete with apparent horns.

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Becoming something else – Tom Leppard -- the so-called "Leopard Man of Skye" -- shot to fame after becoming the world's most tattooed man -- a crown he held until recently. His entire body is covered with leopard spots.

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Becoming something else – English freak and sideshow performer Horace Ridler exhibited himself as "The Great Omi" or "The Zebra Man." Ridler died in 1969.

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Becoming something else – Annette Edwards, a British mother of 10, spent more than 10,000 pounds to transform herself into a real-life Jessica Rabbit, an animated character in the movie "Who Framed Roger Rabbit?"

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Becoming something else – Showman Erik Sprague, also known as "The Lizardman" with his scales and forked tongue, poses for photographs during a 2012 interview in Madrid.

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Becoming something else – Maria Jose Cristerna poses for pictures during a 2011 news conference in Bogota, Colombia. The Mexican tattoo artist said she started to cover her body in tattoos, piercings, titanium implants and dental fangs to reinvent herself as a vampire, her reaction after suffering domestic violence.

No, these aren't features from the latest fantasy film. Today, thousands of people are getting their bodies modified in all sorts of bizarre and unusual ways. Tattoos are just the tip of the iceberg for people interested in body modification, referred to as "body mutilation" by detractors.

People called "body modification artists" perform these unconventional surgical procedures, typically on young clients. These treatments range from the simple, such as implanting metal bolts on a person's neck, to the extreme, such as creating ridges under a person's skin in order to make him look like a human lizard.

Hard to believe? The website Body Modification Ezine has more than 3 million photos of people who've undergone these various types of body modification.

And it's not just in the United States. Other industrialized countries are seeing the body modification trend expand with new, and increasingly bizarre, treatments. In Japan, young people are plumping up their forehead by injecting large amounts of saline, then pressing their thumb into the middle to create an indentation. This leaves a temporary doughnut-like appearance, dubbed the "Bagel Head."

Dr. Anthony Youn

Extreme body modification procedures are almost never performed by actual physicians. These treatments are more often associated with tattoo parlors than medical offices. In fact, I've never heard of a single plastic surgeon who's admitted to performing extreme body modification. And because actual doctors aren't involved, the patients don't benefit from modern anesthetics.

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Although I've never been asked to fix or treat a split tongue, there is one body modification trend I've been asked very commonly to repair: gauge earrings. These are circular earrings that function to gradually dilate an ear piercing, often to massive size. People with gauge earrings may believe their earlobes look stylish when the earrings are in place, but they look like limp noodles when the jewelry is removed.

Most of my patients who've undergone repair of their stretched earlobes have had it done to improve their job prospects -- what works for an interview at a tattoo parlor may not be appropriate when applying for a managerial position.

Apart from its effect on professional prospects, can extreme body modification be a sign of underlying psychiatric issues?

One of the most famous body modification subjects, Dennis Avner, spent years making himself look like a cat. He went so far as to have whiskers implanted into his cheeks and his teeth filed into fangs. About a year ago, he died of an apparent suicide. Some have speculated that Avner may have suffered from body dysmorphic disorder, a psychiatric condition involving a person's self-image. It has a very high rate of suicidal ideation.

As a board-certified plastic surgeon, I'm well aware that the patients in my medical field have a much higher rate of BDD than the general population. Plastic surgery is basically a more socially acceptable form of body modification.

However, there is a big difference between plastic surgery and extreme body modification. Board-certified plastic surgeons are required to undergo at least nine years of schooling and training, pass a slew of rigorous exams and perform their procedures in a safe, accredited medical center.

So if you're considering extreme body modification, think about it very seriously. Surgical procedures should be performed in a sterile medical environment under the hands of an experienced surgeon. Things can go wrong even under the best of circumstances.

Also consider that what you want today may not be want you want in the future. Fashion changes. While it may be cool to have Frankenstein's bolts in your neck now, in 10 years they may just make you look like a monster.